Three different products get sold as “health insurance for the move.” Here is what each is, which residence routes require which, what your US cover does abroad, and what each named insurer publishes.
Three products, three different jobs
Travel medical insurance is short-term cover for a trip. The EU defines it for Schengen purposes in the Visa Code: applicants must hold “adequate and valid travel medical insurance to cover any expenses which might arise in connection with repatriation for medical reasons, urgent medical attention and/or emergency hospital treatment or death,” and “the minimum coverage shall be EUR 30 000” (Regulation (EC) No 810/2009, Article 15, EUR-Lex, checked 2026-08-26). Cigna, which sells both, calls it “short-term, cover usually of six months or less,” with “treatment at the nearest medical facility,” and it “usually requires repatriation to your home nation for long-term care” (Cigna Global, checked 2026-08-26).
International private medical insurance (IPMI) is annual, renewable cover for people who live abroad. Cigna defines it as “medical coverage that covers expatriates living abroad for a long period of time… an annual agreement, unlike the short-term nature of travel insurance,” and its Customer Guide sets the policy term at three to twelve months, renewable (Cigna Global Health Options Customer Guide, EN 02/2026, checked 2026-08-26). IMG sells the two as separate lines: Global Medical Silver, Gold and Platinum under International Health Insurance, Patriot Lite, Plus and Platinum under Travel Medical Insurance (IMG, checked 2026-08-26).
The destination’s public system is the third thing, and often not public in the way you expect. In the Netherlands, “everyone who lives or works in the Netherlands is legally obliged to take out standard health insurance,” sold by private insurers who “must charge all policyholders the same premium, regardless of their age or state of health” (Government of the Netherlands, checked 2026-08-26). That is a compulsory private purchase, not a free service.
The visa condition trap
Several residence routes require private cover before the public system is open to you.
Spain, non-lucrative residence visa. The consular checklist requires “proof of public or private health insurance from an insurance entity recognized and authorized to operate in Spain.” The policy “must cover all the risks insured by Spain’s public health system,” must have no “deficiency, copayment, or coverage limit,” and must be “valid for 1 year and maintained for the entire duration of the stay.” The checklist closes the question directly: “No travel insurances (with medical assistance coverage) will be accepted” (Consular Section, Embassy of Spain in Washington DC, checked 2026-08-26). Spain publishes no euro minimum. Unlimited cover with zero copayment is a higher bar than a number.
Ireland, Stamp 0 for people of independent means. Required documents include “Evidence of private medical insurance with full cover in private hospitals.” The means test is “an individual income of €50,000 per year,” plus a lump sum “equal to, for example, the price of a residential dwelling in the State.” The permission also states “you are not entitled to access State benefits while resident here on a retirement permission” (Irish Immigration Service, checked 2026-08-26).
Italy, elective residence. Under article 34 of Testo Unico 286/98, registration with the Servizio Sanitario Nazionale is compulsory for permits issued for adoption, employed work, self-employed work and family reasons. For every other permit type, elective residence included, the foreign national must instead insure against illness, accident and maternity through a private policy or voluntary SSN registration, “valida anche per i familiari a carico,” which also covers dependants (Ministero degli Affari Esteri, checked 2026-08-26). The ministry publishes no euro minimum for that policy, so none is stated here.
We could not verify France’s long-stay visitor condition at an official source today: france-visas.gouv.fr and legifrance.gouv.fr both refused our requests. It is left out rather than guessed.
What your US cover does abroad
Medicare catches families with a retired parent or grandparent joining the move. “Medicare usually doesn’t cover health care while you’re traveling outside the U.S.” Its definition of outside is broad: the 50 states, DC, Puerto Rico, the US Virgin Islands, Guam, the Northern Mariana Islands and American Samoa count as the US, and “Anywhere else is considered outside the U.S.” On the bill: “You pay all of the costs, in most cases.” Drug coverage does not travel at all: “Medicare drug plans don’t cover prescription drugs you buy outside the U.S.” The exceptions are narrow: each turns on a foreign hospital being closer than a US one, or on Canada transit between Alaska and another state (Medicare.gov, checked 2026-08-26).
Medical evacuation
The State Department’s own instructions to its consular officers say the bill is yours. 7 FAM 361.2: “You need to explain clearly that the patient and/or family are expected to make decisions, to make arrangements and assume costs.” Government help through the EMDA and Repatriation Loan Programs is available “only in limited circumstances.” The same chapter adds that “air ambulance services generally require either payment up front or a guarantee of payment,” and recommends the product: “Purchasing insurance for a medical evacuation prior to travel is a prudent means of ensuring access to such services when an accident or illness occurs in another country” (Foreign Affairs Manual, 7 FAM 360, checked 2026-08-26).
Two insurers publish how they handle it, differently. Cigna sells International Medical Evacuation as an optional module rather than core cover, paid in full on Silver, Gold and Platinum once purchased, and notes that “treatment in the USA is excluded unless the beneficiary has purchased Worldwide including USA cover.” IMG includes Emergency Medical Evacuation inside Global Medical Insurance, at a $50,000 maximum on Bronze and Silver and “up to the Lifetime Maximum” on Gold and Platinum. Check which you bought before you need it.
Maternity and pre-existing conditions
Both are gated by time, and the clock starts with the policy, not with your arrival.
Cigna publishes routine maternity as “available once the mother has been covered by the policy for 12 months or more,” and “24 months or more in Singapore, Hong Kong and the UK.” It is not on Silver at all. Limits are $7,000 on Gold and $14,000 on Platinum.
IMG publishes maternity on Platinum only, “available after 10 or 24 months after Underwriting’s review of the application,” with a “Maternity Deductible: $2,500 (In addition to plan Deductible).”
Pre-existing conditions are underwritten rather than waited out. IMG states its approach as “Full Medical Underwriting”: disclosed conditions are “covered the same as any illness or injury unless excluded by a Rider,” non-disclosed conditions get “No Coverage,” and previously unknown conditions become eligible only “after 24 months of continuous coverage,” capped at $5,000 per period and a $50,000 lifetime maximum. Cigna has the same shape: a condition declared on the medical questionnaire becomes “a special exclusion as detailed on your Certificate of Insurance,” with limited outpatient maintenance benefits for named conditions. Answer the questionnaire completely. Non-disclosure voids the cover you paid for.
Children
Where a rule exists, it is usually a government’s rather than an insurer’s. The Netherlands publishes the clearest one: “Children under the age of 18 must have health insurance but do not pay premiums for the standard package. Parents must register their child with an insurance company within four months of its birth” (Government of the Netherlands, checked 2026-08-26). One insurer publishes a child rule of its own. SafetyWing’s Essential plan lets you “add a child under 10 per adult for free (max 2)” (SafetyWing, checked 2026-08-26).
What each insurer publishes
SafetyWing publishes prices on the page: Nomad Insurance Essential at $62.72 per 4 weeks for ages 18 to 39, Complete at $177.50 per month for the same band, cover “across 180+ countries,” and “US coverage is extra” (checked 2026-08-26).
Cigna and IMG publish benefit tables and deductible ranges but route price to a quote. Cigna’s published deductible ladder is $0, $375, $750, $1,500, $3,000, $7,500 and $10,000, with a cost share of 0, 10, 20 or 30 percent and an out-of-pocket maximum of $2,000 or $5,000. IMG’s runs $250 to $10,000 on Bronze and Silver, $250 to $25,000 on Gold, and $100 to $25,000 on Platinum. Both split the world the same way. Cigna sells “Worldwide, including USA” and “Worldwide, excluding USA.” IMG sells Area 2, “Worldwide excluding United States, Canada, China, Hong Kong, Japan, Singapore and Taiwan,” and Area 3, “Worldwide.” Adding the US is the largest price lever in either.
Allianz Care and William Russell are named because families ask about them. We could not verify anything they publish today: allianzcare.com returned 403 to every request and williamrussell.com refused the connection. Nothing is stated about either until we read their own documents.
We get paid when you request a quote through the form on this site, and that payment does not change a word above.
Who should not
Families whose destination gives them public cover on arrival. If your route enrols you and your children in the public system as soon as residence is registered, IPMI is a second payment for a service you already hold. Buy the local top-up, if any, and stop there. Verify the enrolment rule for your permit type first: the Italian example above shows one country treating work permits and elective residence differently.
Families staying under 90 days. You are not a resident and not eligible for the public system. Cigna’s own comparison puts you in the travel product: short-term, treatment at the nearest facility, repatriation home for anything long-term. Entering the Schengen area, the number that matters is the Visa Code minimum of EUR 30,000, not an annual IPMI plan you cancel in eleven weeks.